Surgery 1993 Oct;114(4):711-7; discussion 717-8

Long-term results of liver transplantation for biliary atresia

Kalayoglu M, D'Alessandro AM, Knechtle SJ, Eckhoff DE, Pirsch JD, Judd R,
Sollinger HW, Hoffmann RM, Belzer FO

Abstract
BACKGROUND. Biliary atresia can be treated by portoenterostomy, which is
primarily palliative, or by liver transplantation, which is primarily curative.
The purpose of this study was to determine the long-term outcome of liver
transplantation for the treatment of biliary atresia. METHODS. During an 8-year
period, 45 patients who underwent liver transplantation for biliary atresia and
10 patients who were referred to our center for portoenterostomy were
retrospectively analyzed. RESULTS. No patient with biliary atresia died awaiting
liver transplantation. The waiting time for all patients was 36.7 +/- 42.8 days.
Thirty-four patients (75.6%) required one transplant, whereas 11 patients
(24.4%) required 17 retransplants. Twenty-two patients (48.9%) required 39
reoperations (1.8 per patient). There were 4.9 infectious episodes, 2.2
rejection episodes, and 4.4 readmissions per patient. However, 91% of
reoperations, 80% of infections, and 78% of rejections occurred within 6 months
of transplantation. The overall 7-year actuarial patient and graft survival for
patients with biliary atresia was 86.2% and 62.7%, respectively. CONCLUSIONS.
Our results indicate that long-term patient survival after liver transplantation
for biliary atresia is excellent. However, portoenterostomy continues to have an
initial complementary but limited long-term role in the treatment of infants
with biliary atresia